Interventional radiotherapy (brachytherapy) achieves very good long‐term quality of life in children and adolescents with soft‐tissue sarcoma

Objective: Comparing the surgical outcomes of the Minimally Invasive Ponto Surgery (MIPS) technique with the linear incision technique with soft tissue preservation (LITT-P) for bone conduction devices after a follow-up of 22 months.Methods: In this multicenter randomized controlled trial, there was the inclusion of 64 adult patients eligible for unilateral surgery. There was 1:1 randomization to the MIPS (test) or the LITT-P (control) group. The primary outcome was an (adverse) soft tissue reaction. Secondary outcomes were pain, loss of sensibility, soft tissue height/overgrowth, skin sagging, implant loss, Implant Stability Quotient measurements, cosmetic scores, and quality of life questionnaires.Results: Sixty-three subjects were analyzed in the intention-to-treat population. No differences were found in the presence of (adverse) soft tissue reactions during complete follow-up. Also, there were no differences in pain, wound dehiscence, skin level, soft tissue overgrowth, and overall quality of life. Loss of sensibility (until 3-month post-surgery), cosmetic scores, and skin sagging outcomes were better in the MIPS group. The Implant Stability Quotient was higher after the LITT-P for different abutment lengths at various points of follow-up. Implant extrusion was nonsignificantly higher after the MIPS (15.2%) compared with LITT-P (3.3%).Conclusion: The long-term results show favorable outcomes for both techniques. The MIPS is a promising technique with some benefits over the LITT-P. Concerns regarding nonsignificantly higher implant loss may be overcome with future developments and research.Clinical Trial Registration:www.ClinicalTrials.gov, identifier: NCT02438618.

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Patient’s quality of life after surgery and radiotherapy for extremity soft tissue sarcoma - a retrospective single-center study over ten years

Health and Quality of Life Outcomes ◽

10.1186/s12955-019-1236-4 ◽

2019 ◽

Vol 17 (1) ◽

Cited By ~ 3

Author(s):

Rebekka Götzl ◽

Sebastian Sterzinger ◽

Sabine Semrau ◽

Nikolaos Vassos ◽

Werner Hohenberger ◽

...

Keyword(s):

Quality Of Life ◽

Radiation Therapy ◽

Soft Tissue ◽

Soft Tissue Sarcoma ◽

Major Complication ◽

Neoadjuvant Radiochemotherapy ◽

Complication Rates ◽

Extremity Soft Tissue Sarcoma ◽

Disease Free

Abstract Background and objectives The purpose of this study is to analyze major complication rates and different aspects of health-related quality of life (HRQoL) in extremity soft tissue sarcoma (STS) patients treated with or without radio (chemo) therapy and surgery. Methods We performed a retrospective analysis of all patients who underwent Extremity STS excision from 2004 to 2014 (182 patients included). Patients’ data were collected from patients’ records. HRQoL was assessed by using EORTC QLQ-C30. Results A total of 182 patients underwent sarcoma resection. After neoadjuvant radiochemotherapy (RCT), the major-complication rate amounted to 28% (vs. 7%, no radiotherapy, p < 0.001). Major-complication rates after adjuvant radiotherapy (RT) occurred in 8% (vs. 7%, no radiotherapy, p = 0.265). Comparison QoL scores between treating with neoadjuvant RCT or without RT revealed significant worse scores with neoadjuvant RCT. Further stratification of disease control of these patients showed significant reduced scores in the group of disease-free patients with neoadjuvant RCT compared to irradiated disease-free patients. Discussion To date, there have only been a few investigations of QoL in STS. Retrospective study on quality of life have limitations, like a lack of baseline evaluation of QoL. Patient candidated to radiation therapy could have had worse QoL baseline due to more advanced disease. Disease status of the patients who answered the questionnaires could have been an influence of QoL and we could show reduced scores in the group of disease-free patients with neoadjuvant RCT, but not for the patients with recurrence or metastasis, so it is very hard to discriminate whether radiation therapy could really have an impact or not. Conclusion This study might assist in further improving the understanding of QoL in STS patients and may animate for prospective studies examining the oncological therapies impact on HRQoL.

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Health-related quality of life (HR-QoL) in elderly soft tissue sarcoma (STS) patients from the randomized phase II EPAZ study comparing pazopanib (PAZ) and doxorubicin (DOX) in first line

Annals of Oncology ◽

10.1093/annonc/mdy299.004 ◽

2018 ◽

Vol 29 ◽

pp. viii577

Author(s):

V. Grünwald ◽

M. Schuler ◽

P. Schöffski ◽

H.-G. Kopp ◽

S. Bauer ◽

...

Keyword(s):

Quality Of Life ◽

Soft Tissue ◽

Soft Tissue Sarcoma ◽

Phase Ii ◽

Health Related Quality ◽

First Line ◽

Randomized Phase Ii ◽

Related Quality ◽

Health Related

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Rehabilitation and quality-of-life issues in patients with extremity soft tissue sarcoma

Current Treatment Options in Oncology ◽

10.1007/s11864-004-0036-0 ◽

2004 ◽

Vol 5 (6) ◽

pp. 477-488 ◽

Cited By ~ 26

Author(s):

Janet A. Parsons ◽

Aileen M. Davis

Keyword(s):

Quality Of Life ◽

Soft Tissue ◽

Soft Tissue Sarcoma ◽

Extremity Soft Tissue Sarcoma ◽

Life Issues

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Quality of life and added value of a tailored palliative care intervention in patients with soft tissue sarcoma undergoing treatment with trabectedin: a multicentre, cluster-randomised trial within the German Interdisciplinary Sarcoma Group (GISG)

BMJ Open ◽

10.1136/bmjopen-2019-035546 ◽

2020 ◽

Vol 10 (8) ◽

pp. e035546

Author(s):

Leopold Hentschel ◽

Stephan Richter ◽

Hans-Georg Kopp ◽

Bernd Kasper ◽

Annegret Kunitz ◽

...

Keyword(s):

Quality Of Life ◽

Soft Tissue ◽

Soft Tissue Sarcoma ◽

Functional Assessment ◽

Patient Reported Outcomes ◽

Statistical Significance ◽

Case Vignette ◽

Cluster Randomised ◽

Patient Reported

ObjectivesThe choice of drug treatment in advanced soft tissue sarcoma (STS) continues to be a challenge regarding efficacy, quality of life (QoL) and toxicity. Unlike other cancer types, where integrating patient-reported outcomes (PRO) has proven to be beneficial for QoL, there is no such evidence in patients with STS as of now. The YonLife trial aimed to explore the effect of a tailored multistep intervention on QoL, symptoms and survival in patients with advanced STS undergoing treatment with trabectedin as well as identifying predictors of QoL.DesignYonLife is a cluster-randomised, open-label, proof-of-concept study. The intervention incorporates electronic PRO assessment, a case vignette and expert-consented treatment recommendations.ParticipantsSix hospitals were randomised to the control arm (CA) or interventional arm (IA). Seventy-nine patients were included of whom 40 were analysed as per-protocol analysis set.Primary and secondary outcome measuresThe primary end point was the change of Functional Assessment for Cancer Therapy (FACT-G) total score after 9 weeks. Secondary outcomes included QoL (FACT-G subscales), anorexia and cachexia (Functional Assessment of Anorexia/Cachexia Therapy (FAACT)), symptoms (MD Anderson Symptom Inventory (MDASI)), anxiety and depression (HADS), pain intensity and interference (Brief Pain Inventory (BPI)) and survival assessment.ResultsAfter 9 weeks of treatment, QoL declined less in the IA (ΔFACT-G total score: −2.4, 95% CI: −9.2 to 4.5) as compared with CA (ΔFACT-G total score: −3.9; 95% CI:−11.3 to 3.5; p=0.765). In almost all FACT-G subscales, average declines were lower in IA, but without reaching statistical significance. Smaller adverse trends between arms were observed for MDASI, FAACT, HADS and BPI scales. These trends failed to reach statistical significance. Overall mean survival was longer in IA (648 days) than in CA (389 days, p=0.110). QoL was predicted by symptom severity, symptom interference, depression and anxiety.ConclusionOur data suggest a potentially favourable effect of an electronic patient-reported outcomes based intervention on QoL that needs to be reappraised in confirmatory studies.Trial registration numberClinicalTrials.gov Identifier (NCT02204111).

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Does palliative chemotherapy really palliate and are we measuring it correctly? A mixed methods longitudinal study of health related quality of life in advanced soft tissue sarcoma

PLoS ONE ◽

10.1371/journal.pone.0210731 ◽

2019 ◽

Vol 14 (9) ◽

pp. e0210731 ◽

Cited By ~ 1

Author(s):

Nicholas Gough ◽

Jonathan Koffman ◽

Joy R. Ross ◽

Julia Riley ◽

Ian Judson

Keyword(s):

Quality Of Life ◽

Longitudinal Study ◽

Soft Tissue ◽

Soft Tissue Sarcoma ◽

Palliative Chemotherapy ◽

Health Related Quality ◽

Advanced Soft Tissue Sarcoma ◽

Related Quality ◽

Health Related

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Long-Term Response after 94 Cycles of Trabectedin in a Patient with Metastatic Leiomyosarcoma of the Lower Extremity

Case Reports in Oncology ◽

10.1159/000505393 ◽

2020 ◽

Vol 13 (1) ◽

pp. 113-119 ◽

Cited By ~ 2

Author(s):

Magda Cordeiro ◽

José Manuel Casanova ◽

Joana Rodrigues ◽

João Freitas ◽

Ruben Fonseca ◽

...

Keyword(s):

Quality Of Life ◽

Soft Tissue ◽

Lower Extremity ◽

Disease Progression ◽

Stable Disease ◽

Case Reports ◽

Soft Tissue Sarcomas ◽

Term Therapy

Leiomyosarcomas of the lower extremity are extremely rare disorders and account for 10–15% of limb soft tissue sarcomas. These tumours have poor prognosis and even in early stages, patients persist at high risk for local and distant relapse; consequently, the treatment of advanced leiomyosarcoma of the lower extremity embodies a substantial defy. We present the case of a 73-year-old man diagnosed with metastatic lower extremity leiomyosarcoma of the hallux soft tissue, and with bone, lung and lymph node metastasis. After core needle biopsy confirmation of high-grade fusocellular sarcoma, the patient underwent surgery of the primary tumour and received anthracycline-based chemotherapy. However, after a 7-month progression-free survival period, a CT revealed lung disease progression. Sequentially, the patient was treated with trabectedin (Yondelis®) at a dose of 1.5 mg/m2 resulting in complete remission of the lung metastasis and stable disease of the remaining lesions after 26 months of treatment. Afterwards, the patient started on maintenance therapy with trabectedin, resulting in long-lasting stable disease, as he was able to receive 94 cycles with very acceptable quality of life. Finally, in March 2019, the patient died of community-acquired pneumonia without objective progression disease. This clinical case reports the first patient ever treated with 94 cycles of trabectedin. Our results additionally confirm that trabectedin wields relevant oncostatic benefits with a manageable safety profile and without cumulative toxicities. Trabectedin properties enable a maintenance long-term therapy (until disease progression or unbearable toxicity), with a high impact on survival and with a preserved quality of life.

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